Over 1.5 million sport-related concussions or mild traumatic brain injuries occur annually in the United States. Increased media and medical attention is focused on these injuries and their potential to cause long-term cognitive, somatic, and affective problems. While detection of the low-level diffuse damage incurred through mTBI needs to take place accurately and quickly, assessment methods have been criticized as insufficiently sensitive and susceptible to motivational and other extraneous factors. Recent research shows that oculomotor performance (e.g., eye movements such as saccades and smooth pursuit) may represent a sensitive biomarker of mTBI.
The present disclosure provides a portable tool for the diagnosis and management of mTBI such as concussions. Such a tool for the detection of concussions is substantially completely automated, and therefore is not influenced by the will of an athlete, a coach, a parent, the media, or a sports fan. The same tool has other uses outside of sports for people with potential mTBIs, for example, in the military.
One exemplary embodiment of a field mTBI assessment tool: (a) evaluates an aspect of brain function that involves a broad range of structures, for example subcortical, cortical, and cerebellar so that diffuse, low level damage has a higher likelihood of detection; (b) is used to conduct a test rapidly following injury; (c) requires minimal time and cost; (d) is portable to sites of injury and recuperation; and (e) provides an assessment that is difficult for the test subject to manipulate in an attempt, for example, to conceal the existence of a concussion.
Thus, herein disclosed is a device to detect mild traumatic brain injury (“mTBI”) by user eye movement which includes a visualization unit comprising a light and a camera, wherein the visualization unit is configured to reflect light off of a user's eye into the camera, a user screen viewable by the user and configured to display a series of tasks to the user, the tasks including at least saccade tasks and pursuit tasks, which require movement of the user's eye, such movements being tracked by the visualization unit, and a first computing device in communication with the visualization unit, wherein the first computing device receives eye movement data from the visualization unit in response to the user performing the series of tasks, the first computing device being configured to calculate a difference between at least one measured variable of the eye movement data when the user is unimpaired and the at least one measured variable after the user experiences a potential mTBI.
In some embodiments, the device is portable and wearable by the user. In other embodiments, the tasks further include at least one of a self-paced saccade task, a sinusoidal pursuit task, a step-ramp pursuit task, an ocular following task, and a dynamic random dot task. In some embodiments, the series of tasks requires between about three and about ten minutes to complete. In other embodiments, the series of tasks requires between about five and about eight minutes to complete. Still in other embodiments, a device configured to measure the user's balance during the series of tasks is included. Still in other embodiments, the device further comprises a second computing device and an operator's screen for operation of the visualization unit. In some embodiments, the device further comprises user controls and an audio unit.
In some other embodiments, the user's unimpaired baseline score for the at least one variable is an average of two baseline task scores for the user taken at two different times when the user is unimpaired. In some embodiments, the user screen and operator screen provide either an indication of likely concussed or likely not concussed based on the difference between the values of at least one measured variable.
Further disclosed is a method of detecting mild traumatic brain injury (“mTBI”) comprising the steps of providing a visualization unit for a user suspected of suffering an mTBI which can track the user's eye movement and record resulting eye movement data by a camera and a first computing device, presenting to the user a series of tasks designed to require the user to move the user's eyes pursuant to specified directions, recording the user's eye movement data in response to the user performing the series of tasks, comparing the user's eye movement data to standard eye movement data for a person not suffering from mTBI, and determining whether the user has suffered an mTBI by analyzing a difference between the user's recorded eye movement data and the eye movement data for a person not suffering from mTBI.
In some embodiments, the visualization unit is portable and wearable by the user. In other embodiments, the tasks further include at least one of a self-paced saccade task, a sinusoidal pursuit task, a step-ramp pursuit task, an ocular following task, and a dynamic random dot task. Still in other embodiments, the method further comprises the step of providing a device configured to measure the user's balance during the series of tasks. In other embodiments, the step of executing further comprises a second computing device and an operator's screen for operation of the visualization unit. Still in other embodiments the visualization unit further comprises user controls and an audio unit.
Some embodiments further include the step of providing a visualization unit for a user not suspected of suffering an mTBI which can track and record the user's eye movement data by a camera and a first computing device, wherein the user's eye movement data provides the user's unimpaired baseline score for the at least one variable. Still other embodiments include providing an indication of likely concussed or likely not concussed based on the difference between the user's recorded eye movement data and the eye movement data for a person not suffering from mTBI.
Additionally disclosed is a system to detect mild traumatic brain injury (“mTBI”) by user eye movement comprising a visualization unit comprising a light and a camera, wherein the visualization unit is configured to reflect light off of a user's eye into the camera, a user screen, wherein the screen is viewable by the user and wherein the screen is configured to display a series of tasks to the user to measure the user's eye movement by the camera, a device for measuring the user's balance during the series of tasks, a first computing device in communication with the visualization unit, wherein the first computing device receives eye movement data from the visualization unit in response to the user performing the series of tasks, the first computing device being configured to calculate a difference between at least one measured variable of the eye movement data when the user is unimpaired and the at least one measured variable after the user experiences a potential mTBI, and software-implemented logic to determine if the difference between the at least one measured variable of the user's eye movement between the user's unimpaired baseline score and the user's mTBI score is great enough to indicate a likelihood of an mTBI.
In some embodiments, the tasks further include at least one of a self-paced saccade task, a sinusoidal pursuit task, a step-ramp pursuit task, an ocular following task, and a dynamic random dot task. Still other embodiments further comprise a second computing device and an operator's screen for operation of the visualization unit. In some embodiments, the visualization unit further comprises user controls and an audio unit. In other embodiments, the user's unimpaired baseline score for the at least one variable is an average of two baseline task scores for the user taken at time when the user is unimpaired. Still in other embodiments, the user screen and operator screen provide either an indication of likely concussed or likely not concussed based on the difference between the values of the at least one measured variable.